BACKGROUND: Extended reality (XR) interventions have the potential to benefit patients undergoing elective cardiac surgical and interventional procedures. However, there are no systematic reviews with meta-analyses to guide clinical care.
AIM: To critically evaluate the evidence on the effectiveness of XR interventions on patient anxiety and pain and other associated outcomes.
DESIGN: Systematic review and meta-analysis following the PRISMA 2020 statement.
DATA SOURCES: A systematic search of five databases (CENTRAL, CINAHL, MEDLINE, PsycInfo, Scopus) from inception to July 2023.
METHODS: Screening and data extraction was conducted independently by multiple reviewers. Stata (Version 17) was used to conduct meta-analyses for patient anxiety and pain. Secondary patient outcomes were summarised in a synthesis. The Cochrane Risk of Bias (Version 2) tool was applied to trials and the NHLBI Study Quality Assessment tools to all other study designs.
RESULTS: Of the 3372 records identified, 22 were included, 10 of which were eligible for inclusion in the meta-analyses. Fifty-seven percent of randomised trials were rated as high risk of bias. Virtual reality (VR) was the only XR technology evaluated. VR significantly reduced pre-procedural anxiety (standardised mean difference: -1.29; 95% confidence interval - 1.96, -0.62, p < 0.001), and peri-procedural anxiety (standardised mean difference: -0.50; 95% confidence interval - 0.83, -0.18, p < 0.003) but did not reduce pain levels, compared with usual care. VR increased pre-procedural knowledge and postsurgical physical and pulmonary function. VR interventions may also improve emotional wellbeing, care delivery and physiological outcomes, but evidence was inconsistent.
CONCLUSIONS: XR potentially benefits cardiac patients undergoing elective invasive procedures and surgery by reducing pre- and peri-procedural anxiety and increasing procedural knowledge and physical function.
RELEVANCE TO CLINICAL PRACTICE: Cardiac nurses' role can be supported by VR interventions to improve the patient experience and several aspects of patient care.
PATIENT OR PUBLIC CONTRIBUTION: Not applicable as this is a systematic review.
| Discipline Area | Score |
|---|---|
| Physician |  |
Physician rater
This review supports VR implementation for patient care.
, McMaster University